return if worse
return if worse
Alcohol withdrawal syndrome is unpredictable so managing AWS with scheduled meds invariably leads to under or over-treatment. CIWA-Ar is the best known severity scale but is lengthy and sometimes challenging to use so many alternatives have been developed. It probably doesn’t matter which scale is used–the benefit of symptom-based treatment over scheduled treatment arises not from the scoring tool but from the frequent reassessments.
BAWS on mdcalc
For patients for whom there is low suspicion of disease or for those simply requiring prophylaxis, a minimum of 100 mg should be
administered intravenously. For those with confirmed or highly suspected disease and for those who have "failed" the 100-mg
regimen (eg, persistent mental status changes or ocular palsy), we recommend a dosage upwards of 500 mg intravenously.
Ann Emerg Med. 2007;50:715-721.
Outpatient alcohol withdrawal management, per ARCA protocol.
Naltrexone 50 mg tabs: half tab on first day then 1 tab daily after eating, Disp x 30
CDZ 25 mg tabs: 1 tab q6h x 2 days, then 1 tab q8h x 2 days, then 1 tab q12h x 2 days, then 1 tab daily x 2 days. Dispense x20.
Folic Acid (B9) 1 mg tabs: 1 tab daily, Disp x 14
Thiamine (B1) 100 mg tabs: 1 tab daily, Disp x 14
Carbamazepine 200 mg tabs: 1 tab q12h, Disp x 14 (7 days)
from Asplund 2004
Dryden Outpatient Opiate Withdrawal Rx 2011
